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Chiropractic Care for Patients with Headaches

16 Oct

Though there are many different types of headaches, many involve both the upper cervical region (the neck) and the head. Between the muscles that attach to the head and neck, the ligaments that hold the vertebrae together, the blood vessels that allow blood to flow to and from the head, and the nerves that allow us to smell, taste, see, smile, wink, stick out our tongue, and so much more, it’s no wonder that the neck is intimately related to the head and therefore headaches.

One structure that sheds additional light on this close relationship between the neck and headaches is called the “myodural bridge” (MDB), which spans between a muscle in the back of the neck called the rectus capitus posterior minor and the protective covering of the spinal cord called the dura mater. This connection sits in close proximity to the vertebral artery, veins, and the first cervical nerve or C1 (the occipital nerve).

So how does this MDB cause headaches? Normally when we move our head and neck, the muscle contraction puts tension on the MDB, transmitting its force to tense up the dura, stabilizing the spinal cord. This prevents infolding of the dura, which can generate pain in the form of a headache.

When an injury such as whiplash occurs, cervical vertebral joint dysfunction and overly tight muscles in this area transmit abnormal tension to the dura mater via the MDB, which (like infolding) can result in headaches. If the injured muscle/s weaken or atrophy, this can further compromise the function of the MDB, leading to chronic (long-term) headaches.

A common symptom of an MDB headache is a throbbing pain, usually on one side of head near the ear/temple area and possibly behind the eye. The headache may last from several minutes to several days and the base of the head is tender to the touch. Typically, head movements intensify the pain/headache and neck pain may or may not be present.

Research shows that chiropractic manipulation, soft tissue therapy, and exercise can significantly benefit patients with headaches, regardless of the cause. But it is easy to understand that treatment directed to this region is necessary to restore function, and discovery of this MDB may play an important role as to why chiropractic care is so effective for headache patients.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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Chiropractic Care vs. Medication for Neck Pain

18 Sep

Neck pain can arise from a multitude of causes, from trauma like sports injuries and car accidents to just sleeping in an awkward position. It can also arise from non-traumatic causes like stress, anxiety, or depression. In the past, we’ve noted how forward head posture can increase the risk of neck pain and headaches. Suffice it to say, neck pain can arise from almost anything, and many times it’s very challenging to figure out the origin!

A recent study involved 272 nonspecific neck pain patients between the ages of 18-65 years who received twelve weeks of one of three treatments: spinal manipulative therapy (SMT); medication; or home exercise with advice (HEA). The primary method of assessing change involved tracking self-reported pain levels at 2, 4, 8, 12, 26, and 52 weeks and secondary measures included self-reported disability, global improvement, medication use, satisfaction, general health status, and adverse effects.

The results showed that SMT had a statistically significant advantage over medication regarding pain relief after 8, 12, 26, and 52 weeks, and HEA was superior to medication at 26 weeks. The study concluded that SMT was more effective than medication in both the short and long term for those with acute and subacute neck pain.

The research team added that 60% of participants in the medication group reported side effects—of which gut irritation and drowsiness were the most common. The SMT group experienced no significant adverse effects, but 46% of the SMT and HEA groups equally reported short-term soreness or achiness.

Another study showed for that for chronic neck pain patients, the COMBINATION of SMT and HEA yielded the best long-term outcomes compared to either one alone, with SMT favored in the acute stage (initial stage) of care. The challenge for doctors is to get people to continue with their exercises after their pain subsides, as studies show the dropout rate can be as high as 90%!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic Care and Migraine Headaches

17 Aug

Migraines affect approximately 15% of the general population and are usually managed by medication. However, this traditional treatment approach is not well tolerated by some migraine sufferers due to side effects. Additionally, some people prefer to avoid the risks associated with taking some medications over the long term.

A systematic literature review of randomized controlled trials (RCTs) involving the use of manual therapies to treat migraines found that chiropractic spinal manipulative therapy (SMT) is equally as effective as the medications propranolol and topiramate in the management of such headaches.

One case report featured the successful outcome of a 24-year-old pregnant female who had a history of migraine headaches starting at age twelve. She had previously tried other forms of care including osteopathy, physical therapy, massage therapy, and medication including a non-steroidal anti-inflammatory with codeine. Due to her pregnancy, she turned to chiropractic care in hopes of achieving relief without the use of medications. The application of spinal manipulative therapy along with other manual therapies led to a satisfying outcome which allowed her to cease using her medication.

Another case study featured a 72-year-old woman with a 60-year history of migraine headaches that included nausea, vomiting, photophobia (light sensitivity), and phonophobia (noise sensitivity). Prior to treatment, the patient averaged one to two migraines per week, which lasted one to three days in duration. Following a course of chiropractic care, her headaches resolved completely, which eliminated the need for any migraine medication. A follow-up seven years later confirmed her continued migraine-free status.

In a case involving a 49-year-old female patient suffering from migraine headaches following a car accident, a twelve-week course of chiropractic care utilizing SMT along with both active and other passive therapies led to significant improvements in the patient’s migraine-related disability and pain.

In another case, a 17-year-old boy fell on his head while pole vaulting and began to experience bipolar disorder symptoms, seizures, sleeping problems, and migraine headaches. After failing to respond to various treatment approaches from numerous physicians, he sought treatment from a doctor of chiropractic at age 23. After four months of chiropractic care, his migraine frequency dropped from three times a week to twice a month. He reported a full recovery after seven months of care, which was sustained at an 18-month follow-up.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Neck Pain and the Facet Joints

15 Jun

Neck pain is one of those conditions that virtually everyone has had at some point in time. The degree of how it can affect one’s life is highly variable—from minimal functional limitations to total disability. So where does neck pain come from and why are the “facet joints” so important?

The anatomy of a vertebrae in the spine is quite unique. There are seven vertebrae that make up the cervical spine. The top vertebra in the neck is called the atlas (C1), which basically swivels around the axis (C2). The atlas and axis allow us to rotate our head, such as when checking traffic or looking over our shoulder. The top two vertebrae (c1 and c2) are uniquely shaped, while the remaining cervical vertebrae (c3-7) are very similar in appearance with a vertebral body in the front and a bony ring with spinous process on the back that protects the spinal cord.

Between each vertebral body is a spinal disk and the processes are connected to the processes of the vertebrae above and below by facet joints.

The facet joints are a major source of neck pain, and injuries to the facet joints are commonly referred as “cervical facet syndrome.” Biomechanical studies show that the capsules that surround the facet joints have many nerve endings and can become highly strained when large amounts of force are applied to the body, such as during a motor vehicle collision.

When this occurs, the combination of inflammation and capsular deformation can lower the threshold in various pain producing receptors in the facet joint. This results in persistent neck pain which can increase with normal movement.

There are many treatment approaches available for persistent neck pain arising from the facet joints, such as spinal manipulation and joint mobilization performed by a doctor of chiropractic.

Home-based self-care recommendations may include specific exercises to stretch and strengthen the cervical spine, nutritional advice, home cervical traction units, a cervical pillow, and cervical curve-retaining techniques.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888 

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic for Neck Pain?… Really?

15 May

There have been MANY studies conducted on the benefits and efficacy of spinal manipulation to treat back pain—so much so that many medical doctors frequently refer patients with back pain to chiropractors for this service. But what about neck pain?

Although it’s taken a little longer to compile the evidence, there is now substantial research to support that spinal manipulation for neck pain is equally effective as it is for low back pain in regards to improving pain levels, function, and quality of life.

Multiple reviews and meta-analyses (studies that evaluate the research over a series of years) indicate that mobilization, manipulation, and exercise all work alone but appear to give the best long-term benefits when used in combination with each other.

In the acute and subacute stages of neck pain, studies show cervical manipulation is more effective than various combinations of analgesics, muscle relaxants, and nonsteroidal anti-inflammatory drugs (NSAIDs) for improving pain and function in both the short and intermediate term.

Studies show that thoracic or mid-back manipulation is also very helpful for patients with neck pain. Chiropractic approaches often include a combination of spinal manipulation, manual cervical traction, figure-8 mobilization, and deep tissue trigger point/active release forms of therapy.

As noted above, the inclusion of exercise yields the best long-term benefits, especially for chronic neck pain.

One such exercise is Cranio-cervical flexion (deep neck flexor strengthening): Tuck the chin inwards, pushing the mid part of the neck backward with or without resisting into your fingers/hands or a towel wrapped around the neck. A gradual crescendo of pressure followed by a gradual release (or decrescendo) works well!

Another great exercise is Fiber Stretching: Side-bend the head and neck while applying gentle over-pressure while simultaneously reaching downward with the opposite arm/hand, searching for tight muscle fibers. Try combining forward and backward rotations and chin glide head movements while applying the over-pressure/reach combinations, and work each tight fiber until it loosens up.

There are many other exercises your doctor of chiropractic can show you, but these are a great start!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Where Does Your Neck Pain Come From?

16 Mar

Let’s first look at the anatomy of the neck in order to better understand the structures of the cervical spine that can generate pain.

Starting at the back of the spine, the facet joints allow us to move our neck and head in all directions, and each facet joint is surrounded by a joint capsule that is rich with nerve endings and when swollen, can generate pain both locally and radiating.

One study of volunteers with existing neck pain looked at the various pathways that pain travels when investigators injected each individual facet joint capsule with normal saline solution. Interestingly, the subjects felt pain in parts of the body other than just the neck.  For example, injecting the C6 facet joint capsule consistently reproduced radiating pain down the arm into the thumb side of the forearm and hand, similar to when a disk herniates and a nerve root is pinched. The primary difference was that a deep aching pain occurred in this area, as opposed to a more geographically well-defined pathway when a disk ruptures and pinches a specific nerve root.

The intervertebral disks are small shock absorbers that lie between each vertebral body. These disks are sort of like a jelly doughnut, which can sometimes leak out and pinch a nerve root producing pain (as well as numbness, tingling, and even weakness) that radiates along the course of the nerve.

Poor posture is perhaps one of the most common causes of neck pain. The muscles in the chest tend to be stronger than those in the upper back and pull the shoulders forward resulting in forward head carriage with protracted shoulders. For each inch of forward head shift, an additional ten pounds is added to the weight of the head, which already weights around ten to twelve pounds. Hence, a five-inch forward head carriage places an additional 50 pound load on the upper back and neck just to hold the head upright!

Doctors of chiropractic are trained to identify these faulty postures and track down the pain generator(s) when a patients presents with neck pain. Through patient education, spinal manipulation, mobilization, exercise training, modalities, and more, chiropractors can greatly help those struggling with neck pain!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org